MEDIUM-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH STRAIGHT TAPERED RECTANGULAR FEMORAL PROSTHESIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Hongwei ^1,2 , GU Weidong ¹ , SUN Junying ²

1Department of Orthopedics, Changzhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou Jiangsu, 213000, P.R.China;;
2Department of Orthopedics, the First Hospital Affiliated to Soochow University. Corresponding author: SUN Junying, E-mail: sun_junying@ hotmail.com;

Corresponding author：

Keywords：

Total hip arthroplasty; Straight tapered rectangular femoral prosthesis; Medium-term effectiveness

DOI：

10.7507/1002-1892.20130131

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Objective To investigate the medium-term effectiveness of straight tapered rectangular femoral prosthesis in total hip arthroplasty (THA). Methods Between May 2004 and June 2006, 58 cases (61 hips) of hip joint disease underwent THA with straight tapered rectangular femoral prosthesis and the clinical data of 43 cases (45 hips) followed up more than 6 years were retrospectively analyzed. There were 21 males (23 hips) and 22 females (22 hips) with an average age of 51.6 years (range, 25-75 years), including 12 cases (12 hips) of congenital developmental dysplasia of the hip, 1 case (1 hip) of osteoarthritis secondary to acetabular dysplasia, 1 case (1 hip) of hip deformity after poliomyelitis, 9 cases (9 hips) of femoral neck fractures, 8 cases (8 hips) of avascular necrosis of the femoral head, 8 cases (8 hips) of osteoarthritis of the hip joint, 2 cases (3 hips) of rheumatoid arthritis, and 2 cases (3 hips) of ankylosing spondylitis. Unilateral replacement was performed in 41 cases and bilateral replacement in 2 cases. The Harris score was 41.7 ± 10.4 before operation. X-ray examination was performed to analyze the location of femoral prostheses and evaluate the stability of the prosthesis-bone interface, and Harris score was used to evaluate the hip function. Results Periprosthetic fracture occurred in 3 hips, and thigh pain in 4 hips after operation. Forty-three cases (45 hips) were followed up 74-99 months (mean, 85 months). Harris score was 87.6 ± 8.3 at last follow-up, showing significant difference when compared with preoperative score (t=23.14, P=0.00). The X-ray examination showed that 9 hips had heterotopic ossification; bone resorption caused by stress shielding was observed at the proximal femur in 42 hips. But the stability of the prosthesis-bone interface was good; no infection or dislocation occurred; and no revision for aseptic loosening was performed in all cases. The survival rate of the femoral prosthesis was 100% during medium-term follow-up. Conclusion THA with straight tapered rectangular femoral prosthesis has good medium-term effectiveness.

Citation： LIU Hongwei,GU Weidong,SUN Junying. MEDIUM-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH STRAIGHT TAPERED RECTANGULAR FEMORAL PROSTHESIS. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(5): 594-598. doi: 10.7507/1002-1892.20130131 Copy

1.	Poss R, Walker P, Spector M, et al. Strategies for improving fixation of femoral components in total hip arthroplasty. Clin Orthop Relat Res, 1988, (235): 181-194.
2.	Nakamura Y, Mitusui H, Kikuchi A, et al. Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique. J Arthroplasty, 2011, 26(1): 77-81.
3.	Kim YH, Park JW, Kim JS. Is diaphyseal stem fixation necessary for primary total hip arthroplasty in patients with osteoporotic bone (Class C bone)? J Arthroplasty, 2013, 28(1): 139-146. e1.
4.	朱力波, 马金忠, 王建东, 等. C2非骨水泥股骨柄在人工髋关节置换中的应用. 中国临床医学, 2007, 14(2): 231-232.
5.	马金忠, 俞银贤, 朱力波, 等. 生物固定C2型股骨柄对股骨近端应力遮挡影响的临床研究. 中华关节外科杂志(电子版), 2008, 2(5): 516-520.
6.	Engh CA, McGovern TF, Bobyn DJ, et al. A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg (Am), 1992, 74-A(7): 1009-1012.
7.	Goetz DD, Smith EJ, Harris WH. The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacement. A retrospective matched-pair series. J Bone Joint Surg (Am), 1994, 72(8): 1121-1129.
8.	Engh CA Jr, McAuley JP, Sychterz CJ, et al. The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis. J Bone Joint Surg (Am), 2000, 82-A(10): 1414-1420.
9.	Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
10.	Lavernia C, D’Apuzzo M, Hernandez V, et al. Thigh pain in primary total hip arthroplasty: the effects of elastic moduli. J Arthroplasty, 2004, 19(7 Suppl 2): 10-16.
11.	毛宾尧, 李新春, 王毳, 等. 解剖型羟基磷灰石喷涂Ribbed股骨柄和臼杯全髋关节置换术患者的8年随访观察. 中华关节外科杂志(电子版), 2010, 4(4): 494-499.
12.	Danesh-Clough T, Bourne RB, Rorabeck CH, et al. The mid-term results of a dual offset uncemented stem for total hip arthroplasty. J Arthroplasty, 2007, 22(2): 195-203.
13.	Korovessis P, Repantis T, Zafiropoulos A. High medium-term survivorship and durability of Zweymüller-Plus total hip arthroplasty. Arch Orthop Trauma Surg, 2011, 131(5): 603-611.
14.	Weissinger M, Helmreich C, Pöll G. Results covering 20 years use of the cement-free Zweymüller Alloclassic total endoprosthesis of the hip joint. Acta Chir Orthop Traumatol Cech, 2010, 77(3): 186-193.
15.	唐际存, 王梨明, 胡译文, 等. 矩形柄人工髋关节置换治疗老年股骨转子间粉碎性骨折. 中国修复重建外科杂志, 2011, 25(11): 1400-1402.
16.	贾世孔, 肖晟, 张寅龙. BetaCone双锥度生物固定型髋关节柄在严重骨质疏松全髋关节置换中的早期应用. 中国组织工程研究与临床康复, 2008, 12(30): 5801-5804.
17.	Boyle C, Kim IY. Comparison of different hip prosthesis shapes considering micro-level bone remodeling and stress-shielding criteria using three-dimensional design space topology optimization. J Biomech, 2011, 44(9): 1722-1728.
18.	Karachalios T, Tsalsaronis C, Efraimis G, et al. The long-term clinical relevance atrophy caused by stress shielding in total hip arthroplasty: a 10-year, prospective, randomized study. J Arthroplasty, 2004, 19(4): 469-475.
19.	刘延青, 刘岩, 张克, 等. 非骨水泥近端固定股骨柄和远端固定股骨柄中期随访时骨丢失的X线片表现. 中国修复重建外科杂志, 2007, 21(8): 805-809.
20.	Hwang BH, Lee WS, Park KK, et al. Straight tapered titanium stem with alumina bearing in cementless primary total hip arthroplasty: a minimum 5-year follow-up. J Arthroplasty, 2011, 26(8): 1310-1317.

1. Poss R, Walker P, Spector M, et al. Strategies for improving fixation of femoral components in total hip arthroplasty. Clin Orthop Relat Res, 1988, (235): 181-194.
2. Nakamura Y, Mitusui H, Kikuchi A, et al. Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique. J Arthroplasty, 2011, 26(1): 77-81.
3. Kim YH, Park JW, Kim JS. Is diaphyseal stem fixation necessary for primary total hip arthroplasty in patients with osteoporotic bone (Class C bone)? J Arthroplasty, 2013, 28(1): 139-146. e1.
4. 朱力波, 马金忠, 王建东, 等. C2非骨水泥股骨柄在人工髋关节置换中的应用. 中国临床医学, 2007, 14(2): 231-232.
5. 马金忠, 俞银贤, 朱力波, 等. 生物固定C2型股骨柄对股骨近端应力遮挡影响的临床研究. 中华关节外科杂志(电子版), 2008, 2(5): 516-520.
6. Engh CA, McGovern TF, Bobyn DJ, et al. A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg (Am), 1992, 74-A(7): 1009-1012.
7. Goetz DD, Smith EJ, Harris WH. The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacement. A retrospective matched-pair series. J Bone Joint Surg (Am), 1994, 72(8): 1121-1129.
8. Engh CA Jr, McAuley JP, Sychterz CJ, et al. The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis. J Bone Joint Surg (Am), 2000, 82-A(10): 1414-1420.
9. Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
10. Lavernia C, D’Apuzzo M, Hernandez V, et al. Thigh pain in primary total hip arthroplasty: the effects of elastic moduli. J Arthroplasty, 2004, 19(7 Suppl 2): 10-16.
11. 毛宾尧, 李新春, 王毳, 等. 解剖型羟基磷灰石喷涂Ribbed股骨柄和臼杯全髋关节置换术患者的8年随访观察. 中华关节外科杂志(电子版), 2010, 4(4): 494-499.
12. Danesh-Clough T, Bourne RB, Rorabeck CH, et al. The mid-term results of a dual offset uncemented stem for total hip arthroplasty. J Arthroplasty, 2007, 22(2): 195-203.
13. Korovessis P, Repantis T, Zafiropoulos A. High medium-term survivorship and durability of Zweymüller-Plus total hip arthroplasty. Arch Orthop Trauma Surg, 2011, 131(5): 603-611.
14. Weissinger M, Helmreich C, Pöll G. Results covering 20 years use of the cement-free Zweymüller Alloclassic total endoprosthesis of the hip joint. Acta Chir Orthop Traumatol Cech, 2010, 77(3): 186-193.
15. 唐际存, 王梨明, 胡译文, 等. 矩形柄人工髋关节置换治疗老年股骨转子间粉碎性骨折. 中国修复重建外科杂志, 2011, 25(11): 1400-1402.
16. 贾世孔, 肖晟, 张寅龙. BetaCone双锥度生物固定型髋关节柄在严重骨质疏松全髋关节置换中的早期应用. 中国组织工程研究与临床康复, 2008, 12(30): 5801-5804.
17. Boyle C, Kim IY. Comparison of different hip prosthesis shapes considering micro-level bone remodeling and stress-shielding criteria using three-dimensional design space topology optimization. J Biomech, 2011, 44(9): 1722-1728.
18. Karachalios T, Tsalsaronis C, Efraimis G, et al. The long-term clinical relevance atrophy caused by stress shielding in total hip arthroplasty: a 10-year, prospective, randomized study. J Arthroplasty, 2004, 19(4): 469-475.
19. 刘延青, 刘岩, 张克, 等. 非骨水泥近端固定股骨柄和远端固定股骨柄中期随访时骨丢失的X线片表现. 中国修复重建外科杂志, 2007, 21(8): 805-809.
20. Hwang BH, Lee WS, Park KK, et al. Straight tapered titanium stem with alumina bearing in cementless primary total hip arthroplasty: a minimum 5-year follow-up. J Arthroplasty, 2011, 26(8): 1310-1317.

Chinese Journal of Reparative and Reconstructive Surgery

MEDIUM-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH STRAIGHT TAPERED RECTANGULAR FEMORAL PROSTHESIS

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